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Shira Simon, Alice T Lyon, Lee M Jampol; Evaluation of the Impact of Retinopathy Screenings for Potential Heart Transplant Candidates. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1435.
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Screening for retinopathy in heart transplant candidates is broadly accepted as standard procedure in many hospitals’ and insurance companies’ screening protocols and is a common reason for ophthalmic consultation in hospitalized patients. However, no studies exist to date evaluating the prevalence of retinopathy found in this population, nor the value of these screenings in terms of influencing whether a patient is eligible to receive a transplant. We performed a retrospective chart review to determine the incidence of retinopathy among heart transplant candidates at a tertiary medical center in order to assess the effectiveness of this screening request.
We conducted a retrospective chart review of all heart transplant candidates over the age of 21 from March 2008 to Oct 2014 at Northwestern Memorial Hospital. Ophthalmic examination with indirect ophthalmoscopy was performed by both a resident and a supervising attending on each inpatient consultation. The data gathered included age and gender of the patient, whether an eye evaluation was conducted, whether retinopathy was found, whether the candidate received a heart transplant, the rationale if a patient was rejected from heart transplant candidacy, and survival rate among the transplanted population with retinopathy.
There were 387 heart transplant evaluations undertaken since 2008. 158 (41%) of these had consult requests for evaluation of retinopathy. 66% of patients were male, and 33% were female. Age ranged from 21 to 70, with a mean age of 54 years. Of the 158 evaluated, 16 (10%) were found to have retinopathy. Of these retinopathy patients, 1 ( 0.63%) was excluded from transplant eligibility on the basis of this finding.
Retinopathy is an infrequent finding in hospitalized patients undergoing heart transplant evaluation. When found, it seems to play a negligible and inconsistent role in whether the patient receives a transplant. Reconsideration of this routine screening criterion seems warranted in order to minimize unnecessary procedures and to ensure more effective and efficient healthcare delivery and systems.
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